The name „Skier's thumb” refers to the partial or total tear of the thumb’s ulnar collateral ligament (UCL). Being the result of a skiing accident, the ulnar collateral ligament is deteriorated when a sudden force is placed on the thumb. Usually, this happens when the hand is wrapped around the ski pole and, during a fall, the pole stops suddenly, but the skier doesn’t.

Approximatively 8-10% of ski accidents refer to lesions of the ulnar collateral ligament.

The ulnar collateral ligament is located at the basis of the thumb, next to the palm, preventing the thumb from bending too much or to become dislocated. This ligament keeps the thumb stable when pinching or grabbing objects.

In case of ski accidents, this ligament is stretched or torn, leading to the occurrence of pain and limited movement of the thumb.

For confirming a lesion of the ulnar collateral ligament, a physical examination is performed, as well as an X-Ray for confirming the obvious lesions, such as joint laxity or bone fractures.

Except for ski, the thumb’s ulnar collateral ligament can also be damaged in contact sports or ball sports, or in case of bike falls when the thumb grabs the handlebar.

A chronical version, named “Gamekeeper's thumb”, occurs when repeated movements, specific to computer games/ phone games gradually stretch and tear the ulnar collateral ligament.

Skier's thumb is also a frequently encountered lesion due to car accidents when drivers keep their thumbs outside the steering wheel (draped over the steering wheel).

Symptoms include sensibility, tumefaction (swelling), bruising, redness and pain at the basis of the thumb and in the space between the thumb and index finger.

Pain can extend to the hand wrist and can be exacerbated by thumb or hand movements.

Instability can also be manifested at the level of the thumb, as well as at the level of the thumb metacarpophalangeal joint (phalanges are bone fingers and metacarpal bones are the bones on the dorsal part of the hand).

Depending on the lesion’s severity, symptoms can remain local (at the level of the thumb) or can become expanded at the level of the entire hand.

Moreover, grabbing and holding objects (pencil, fork, etc.) will be difficult or painful, as well as rotating or pressing a door handle.

Depending on the lesion’s severity, therapeutical options include:

Activities or movements determining, or aggravating pain will be interrupted.

Also, the use of the affected hand will also be limited.

The thumb will be wrapped in a compression bandage in order to apply mild pressure on the lesion, and the hand will be maintained elevated above heart level, in order to reduce tumefaction.

For allowing complete recuperation, the thumb will be immobilized in a splint for several weeks.

Ice applied locally, in 20-minute sessions, ideally from hour to hour, significantly helps reduce swelling and pain.

Ice will be wrapped in a thin towel, in order not to irritate the skin.

Non-steroidal anti-inflammatory drugs, such as ibuprofen or naproxen, as tablets or local ointments, may help reduce swelling and alleviate pain. However, these are recommended for short periods, of maximum 7-14 days.

A physical exercises program is essential for increasing mobility (increasing the movement scope) and for toning (hardening) thumb muscles, hand joint and the entire hand.

Increasing the stability of the ulnar collateral ligament is important since it has an important role in the object grabbing function.

If the lesion is severe or included a complete ligament rupture, or the damage of other tissues, surgical intervention is necessary. After the intervention, a splint will be worn for 1 month while the lesion heals, and then a recovery program will be commenced by physical therapy, in order to prevent stiffness of the affected thumb and of the hand.

If not healed properly, the affection can relapse. Also, it can become a chronical affection, leading to long-term pain, instability or weakness of the fingers, hand and hand joint. In time, arthritis can occur in the joints or at the basis of the thumb, causing additional pain, stiffness and limited movement of the thumb.

➢ Although not all accidents can be prevented, the throwing the ski poles during a fall can be trained

➢ Changing the adherence of thumbs to the steering wheel can help prevent the development of the skier's thumb after a car accident

➢ Time spent playing computer games will be limited